关于成人慢性肠衰竭的ESPEN指南 - 2023年更新
Loris Pironi1, Cristina Cuerda2, Palle Bekker Jeppesen3
1Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Center for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy.
Clinical nutrition (Edinburgh, Scotland)
|August 28, 2023
概括
针对成人慢性肠衰竭 (CIF) 的最新ESPEN指南包含了新的证据. CIF的管理需要复杂的,专业的多学科护理和先进的家庭亲肠道营养 (HPN) 技术.
科学领域:
- 胃肠病学 胃肠病学
- 临床营养学 临床营养学
- 基于证据的医学基于证据的医学.
背景情况:
- 欧洲亲肠和肠道营养学会 (ESPEN) 在2016年发布了成人慢性肠衰竭 (CIF) 的指导方针.
- 制定了更新的指导方针,以纳入新的证据,并完善因良性疾病导致的CIF管理的建议.
研究的目的:
- 为成人慢性肠衰竭 (CIF) 的管理提供最新的,基于证据的建议.
- 解决新的领域,包括IF中心,慢性皮内囊和怀孕期间的患者护理以及从儿科到成人护理的过渡.
主要方法:
- 文学评分使用了苏格兰大学间指南网络 (SIGN) 系统.
- 建议使用A (强),B (有条件),0 (弱) 和良好实践点 (GPP) 进行评级.
- 新的建议和章节被制定,现有的建议和章节被审查,重写和重新评分.
主要成果:
- 更新的指导方针包括149个建议和16个声明,在大多数情况下达成强有力的共识.
- 大多数建议被评为良好实践 (GPP) (64.4%),很大一部分也被评为弱 (19.5%) 或有条件 (12.7%).
- 只有3.4%的建议获得了强烈的A等级.
结论:
- 慢性肠衰竭 (CIF) 的管理是复杂的,需要专门的技术和多学科的专业知识.
- 家庭亲肠道营养 (HPN) 是CIF管理的关键组成部分.
- 尽管大多数建议都是GPP,但强烈的共识表明人们对专家领导的综合护理方法的必要性达成了高度共识.
相关概念视频
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
199
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
199
Chronic Pancreatitis II: Collaborative Care
113
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
113
Chronic Kidney Disease III: Interprofessional Care
42
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
42
Chronic Kidney Disease IV: Nursing Management
25
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
25
Esophageal Varices-II: Clinical Features and Management
94
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
94
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
354
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
354


